Facility Evaluation Report
On 03/08/2024 at 08:30 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were three (3) staff present, and five (5) residents present. Licensee/Administrator Lesley Vannoy was contacted and arrived during the visit. LPA Brown explained the purpose of the visit to Licensee/Administrator Vannoy.
The facility is a six (6) bedroom, three (3) bathroom home with a kitchen/dining area, living room, laundry room and detached garage. The facility is Residential Care Facility for the Elderly (RCFE). The facility is licensed for a capacity of six (6) residents of which two (2) can be non-ambulatory residents. The facility has two (2) Hospice Waiver. The current census is five (5) residents. LPA Brown was accompanied by Staff #4 (S4) to conduct a general overall inspection, which included, but was not limited to, the following:
Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). LPA Brown observed no obstructions to outdoor and indoor passageways. The facility is maintained at a comfortable temperature. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA Brown observed grab bars and non-skid mat in the resident bathrooms. Also, LPA Brown observed Resident #5 (R5) with full bed rails and Licensee/Administrator Vannoy reported to LPA Brown that R5 is not on Hospice Care and no written order from the physician was observed indicating the need for postural support/full bed rail. LPA Brown observed no exception letter submitted and approved by Community Care Licensing Division (CCLD) for R5's full bed rail. Deficiency will be issued. To add to that, LPA Brown observed Resident #1 (R1), Resident #3 (R3), and Resident #4 (R4) have half bed rails and no written order from their physician indicating the need for half bed rail for mobility. Deficiency will be issued. ***Continuation in LIC809C ***
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction